The risk of sudden unexpected infant death (SUID) and sudden infant death syndrome (SIDS) increased during the COVID-19 pandemic compared to the pre-pandemic period, especially in 2021, according to a new study led by Penn State College researchers. of Medicine. The monthly increases in SUID in 2021 coincided with a resurgence of seasonal respiratory viruses, particularly respiratory syncytial virus (RSV), suggesting that the change in SUID rates may be associated with altered transmission of infectious diseases.
They published their findings today (September 26) in JAMA Network open.
“The cause of SUID is believed to be multifactorial. Even with education on safe sleeping environments and the back-sleeping campaign that encourages parents to put babies to sleep on their backs, there is still a high rate of SUID.” said Emma Guare, a fourth-year medical student at Penn State College of Medicine and first author of the paper. “It has been hypothesized that there could be a link between infection and SUID and we wanted to better understand that connection, particularly as endemic infection rates changed during the pandemic.”
In 2022, approximately 3,700 babies died unexpectedly in the United States, according to the Centers for Disease Control and Prevention (CDC). SUID is a general term for the unexpected death of a baby under one year of age from known and unknown causes. SIDS is a type of SUID that occurs during sleep and where the cause of death is unknown, even after a full investigation, and accounts for approximately one-third of SUID cases.
The research team examined the rate of SUID and SIDS during the COVID-19 pandemic and compared it to the immediate period before the pandemic. Between March 1, 2018 and December 31, 2021, there were 14,308 cases of SUID, according to national mortality data provided by the CDC.
The research team found that the risk of SUID and SIDS increased during the pandemic when they compared monthly cases to the pre-pandemic period. The largest increase was seen in 2021, when SUID and SIDS rates increased by 9% and 10%, respectively, compared to the pre-pandemic period. There was a notable change in SUID rates from June to December 2021, when the monthly SUID rate increased by 10% to 14% compared to pre-pandemic levels.
Measures put in place to mitigate the pandemic also interrupted the spread of respiratory diseases like RSV, keeping rates low throughout 2020. However, when these measures were lifted during the second year of the pandemic, seasonal respiratory viruses began to circulate more widely. at unexpected moments. and with more intensity.
While there were few RSV-related hospitalizations in 2020, cases increased between June and December 2021, a “low season” for RSV, which is typically active between October and April. This seasonal change in RSV closely mirrored the monthly changes in SUID that were observed in 2021.
“We don’t know what makes babies who die from SUID or SIDS more vulnerable, whether it’s genetics or something else. It could be that infections like RSV amplify those factors and make them more vulnerable,” said co-author Erich Batra, associate professor of pediatrics and family and community medicine at Penn State College of Medicine. “With RSV in particular, there have been questions about whether RSV causes more apnea, when you temporarily stop breathing, than other viruses and whether that contributes to an environment conducive to SUID.”
The team noted that more research is needed to better understand the role of infection in SUID and SIDS and whether infections such as RSV may contribute to a portion of SUID and SIDS cases.
“Practicing safe sleep practices is just as important, if not more so, when babies are sick,” Batra said. She encouraged caregivers to continue placing babies on their backs to sleep, avoid soft bedding and not share beds.
Other authors of the Penn State College of Medicine paper include Catharine Paules, associate professor of medicine; Vernon Chinchili, Distinguished Professor of Public Health Sciences; Paddy Ssentongo, assistant professor of public health sciences; and Rong Zhao, PhD student in biostatistics.